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Linear growth is a biological process of fundamental importance to the physical and psychological make-up of a child and adolescent but which can be subject to a number of interruptions and disorders. The management and treatement of patients with growth disorders constitutes a major, and important, part of practice in clinical pediatrics, while in public health terms growth assessment remains one of the most useful indices of health and economic well being in both developed and the developing world. This book approaches growth and its disorders from both a physiological and pathophsyiological standpoint. The book outlines in detail the fundamental biological mechanisms of normal and abnormal linear growth, how to assess growth accurately fundamental to the early detection of abnormatlity and, importantly, how to manage disorders leading to short and tall stature, and disorders of the timing of puberty. Throughout, emphasis is given on achieving a satisfactory outcome for the child and parent by keeping them fully informed as to what is possible from a particular treatment strategy. The result is a wide-ranging and balanced account of this challenging field drawing on the expertise of a team of international specialists from a variety of backgrounds.
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Growth Disorders Second Edition Christopher J. H. Kelnar Professor of Paediatric Endocrinology University of Edinburgh, UK Martin O. Savage Professor of Paediatric Endocrinology Barts and the London School of Medicine and Dentistry, UK Paul Saenger Professor of Pediatrics Albert Einstein College of Medicine, USA Chris T. Cowell Clinical Associate Professor, Director of Clinical Research, and Head Institute of Endocrinology and Diabetes University of Sydney, Australia First published in Great Britain in 1998 by Chapman & Hall This second edition published in 2007 by Hodder Arnold, an imprint of Hodder Education and a member of the Hodder Headline Group, an Hachette Livre UK Company 338 Euston Road, London NW1 3BH www.hoddereducation.com © 2007 Edward Arnold (Publishers) Ltd All rights reserved. Apart from any use permitted under UK copyright law, this publication may only be reproduced, stored or transmitted, in any form, or by any means with prior permission in writing of the publishers or in the case of reprographic production in accordance with the terms of licences issued by the Copyright Licensing Agency. In the United Kingdom such licences are issued by the Copyright Licensing Agency: Saffron House, 6-10 Kirby Street, London EC1N 8TS. Whilst the advice and information in this book are believed to be true and accurate at the date of going to press, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. In particular (but without limiting the generality of the preceding disclaimer) every effort has been made to check drug dosages; however it is still possible that errors have been missed. Furthermore, dosage schedules are constantly being revised and new side-effects recognized. For these reasons the reader is strongly urged to consult the drug companies’ printed instructions before administering any of the drugs recommended in this book. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress ISBN 978 0 340 81240 2 1 2 3 4 5 6 7 8 9 10 Commissioning Editor: Project Editor: Production Controller: Cover Designer: Indexer: Sarah Burrows Francesca Naish Joanna Walker Helen Townson Laurence Errington Typeset in 10/12 Minion by Charon Tec Ltd (A Macmillan Company), Chennai, India www.charontec.com Printed and bou